Fill out the form below to pay your invoice

Patient First Name
Patient Last Name
Patient Date of Birth
Phone Number
Email Address
Patient Address
Invoice Number
Amount in USD $

Pay Your Bill Online

Easily and Securely

In order to pay your bill online, please fill out the form below completely. After completion of the form, you will be prompted to PayPal where you will complete the transaction. You MUST have an invoice in order to submit your payment online. 

Call Us:  407-786-0004

Please note that your transaction is not complete until you submit the payment through PayPal. You will receive a receipt of the payment in the mail 3-5 business days after your payment has been successfully processed.